Analysis Of The Effect Of Laparoscopic Repair Combined With Abdominal Wall And Stoma Rebuild In The Treatment Of Parastomal Hernia

Objective To compare the clinical data of 49 patients collected by our hospital in general surgery to analyze the clinical efficacy of the two surgical methods,and to investigate the safety,feasibility and superiority of laparoscopic repair combined with abdominal wall and stoma rebuild in the treatment of parastomal hernia.Methods The clinical data of 49 patients with parastomal hernia admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed.According to the inclusion and exclusion criteria,49 cases were finally include d,according to the mode of operation,the patients were divided into control group and observation group,27 patients underwent laparoscopic repair surgery(control group),and laparoscopic repair combined with abdominal wall and stomy reconstruction were performed in 22 patients(observation group).The operative time,intraoperative blood loss,intraoperative diameter of hernia ring,postoperative recovery time of intestinal function,postoperative complications,postoperative colostomy-related complicat ions and postoperative recurrence were compared between the two groups.And the defecation score and quality of life score of parastomal hernia were compared.Results General information: There were no significant differences in gender,age,BMI,diameter of CT hernia ring and area of CT hernia sac between the two groups of patients(P> 0.05).Intraoperative data:There was no significant difference in operation time(107.4±15.4 min vs 116.2±22.3 min),intraoperative hernia ring(8.5±3.7cm vs 8.9±3.1 cm)and postoperative recovery time between the two groups(P>0.05).Compared with the control group,the intraoperative blood loss in the observation group was(64.3±21.3)ml,which was greater than(52.6±16.0)ml in the laparoscopic group,and the difference was statistically significant(P=0.03).Postoperative recovery:postoperative anal exhaust time was 23.1±4.8h and 21.4±4.4h in the two groups,with no significant difference(p>0.05),the time to resume eating in the two groups was49.1±8.6h and 48.8±8.4h,there is no significant difference(p>0.05),the time of hospitalization in the two groups was 7.2±2.1d and 7.4±1.9d,and there was no significant difference(P>0.05).There was no significant difference between the two groups in terms of postoperative infection,chronic pain,serous swelling and intestinal obstruction(P>0.05).There was no significant difference between the two groups in terms of Colostomy prolapse,colostomy retraction,colostomy stenosis and colostomy ischemia(P>0.05).The postoperative recurrence rate in the observation group was 4.5%,which was lower than 29.6% in the control group.The difference was statistically significant.The observation group’s postoperative stoma defecation functional score was better than the control group(p=0.03,0.02,0.04)in terms of sensory ability,defecation frequency and whether the clothes would be soiled without stoma(p=0.03,0.02,0.04),the difference was statistically significant.The quality of life scores of the observation group were better than those of the control group in both physical and psychological aspects(p=0.04,0.01),and the difference was statistically significant.Conclusion 1.Laparoscopic repair combined with abdominal wall and stoma rebuild is a safe and effective surgical metho d.2.Low recurrence rate after laparoscopic repair combined with abdominal wall and stoma rebuild.3.Laparoscopic repair combined with abdominal wall and stoma rebuild can enhance the aesthetics of abdominal wall,improve the defecation function of stoma and improve the quality of life of patients after operation.